Maintenance Immunosuppression in Kidney Transplantation: A Review of the Current Status and Future Directions.
A current review of long-term anti-rejection therapy after kidney transplantation finds that mycophenolic acid plus calcineurin inhibitors remain the backbone, but their long-term graft-survival benefit is limited, and alternatives such as belatacept and mTOR inhibitors carry their own rejection trade-offs.
Background
Kidney transplantation is the gold standard for end-stage kidney disease, and its success depends on effective maintenance immunosuppression that prevents rejection while preserving graft function.
Key findings
Mycophenolic acid and calcineurin inhibitors remain the backbone of modern maintenance therapy and have markedly reduced acute rejection, but their long-term efficacy for graft survival remains suboptimal. Belatacept and mTOR inhibitors offer potential benefits, yet concerns about increased rejection have limited their adoption as primary agents.
Clinical implications
The review highlights ongoing efforts to refine steroid- and calcineurin-inhibitor-sparing strategies and identifies practical, quantifiable biomarkers for predicting long-term graft survival as a critical objective for personalizing immunosuppression.
Category
Transplant
Source
Journal of Clinical Medicine
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